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South Dakota rates for HCPCS J1427

Injection, viltolarsen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.68 / $67.68 / $67.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.17 / $67.68 / $67.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.40 / $56.40 / $56.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.40 / $56.96 / $70.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.68 / $87.10 / $166.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.40 / $56.40 / $62.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.73 / $67.73 / $67.73
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.53 / $57.53 / $57.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.40 / $56.40 / $62.04
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.40 / $56.40 / $56.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.40 / $56.40 / $56.40